The relationship between perceived helicopter parenting and diabetes management and self-efficacy, medication adherence, psychological resilience, and anxiety/depression in adolescents with Type 1 diabetes

Aim: Medication adherence in adolescents diagnosed with Type 1 diabetes is a critical determinant for disease management, prevention of long-term complications, and achieving optimal glycemic control. In this adherence process, parental attitudes play an important role alongside the individual dynamics of adolescents. In this context, our study aims to examine, with a holistic approach, both individual factors (self-efficacy, anxiety, depression, and psychological resilience) that may affect medication adherence and the role of perceived helicopter parenting on medication adherence, diabetes management, self-efficacy, anxiety, depression, and psychological resilience. Material and methods: This cross-sectional study was conducted at the Pediatric Endocrinology Outpatient Clinic of Dicle University Faculty of Medicine Children's Hospital, with the participation of 142 adolescents aged 12–18 diagnosed with Type 1 Diabetes Mellitus (DM). The participants completed the Morisky Treatment Adherence Scale, the Diabetes Management Self-Efficacy Scale for Adolescents with Type 1 Diabetes, the Hospital Anxiety and Depression Scale, the Child and Adolescent Psychological Resilience Scale, and the Perceived Helicopter Parenting Attitude Scale. Results: In correlation analyses, significant relationships emerged between medication adherence and psychological resilience (r = 0.488; p < 0.001) and between medication adherence and diabetes self-efficacy level (r = −0.501; p < 0.001). Medication adherence was also significantly negatively correlated with anxiety level (r = −0.242; p = 0.004). Perceived maternal helicopter parenting showed weak but significant positive correlations with depression (r = 0.177; p = 0.037) and with anxiety (r = 0.207; p = 0.014). Perceived paternal helicopter parenting exhibited a weak but significant positive relationship with depression (r = 0.185; p = 0.029). In group analyses based on levels of medication adherence, significant differences were found in diabetes management self-efficacy, anxiety, depression, and psychological resilience (p < 0.001). The high-adherence group displayed higher self-efficacy and psychological resilience levels, while their anxiety and depression levels were significantly lower. In multiple linear regression analysis, variables with significant effects on medication adherence were identified as psychological resilience (β = 0.046; p = 0.007), diabetes management self-efficacy (β = −0.035; p = 0.002), and anxiety levels (β = −0.085; p = 0.015). Examining relationships between medication adherence and helicopter parenting subdimensions, medication adherence scores showed weak but statistically significant negative correlations with maternal basic trust (r = −0.167; p = 0.048), maternal ethics (r = −0.181; p = 0.032), paternal basic trust (r = −0.194; p = 0.022), and paternal ethics (r = −0.186; p = 0.028). Conclusion: In our study, significant relationships were identified between medication adherence and diabetes management self-efficacy, psychological resilience, and anxiety levels. In the group analysis by adherence level, the low-adherence group exhibited markedly higher depression levels. Additionally, significant correlations were observed between subdimensions of the helicopter parenting scale and medication adherence. Our findings indicate that, alongside individual factors, parental attitudes also act as determinants in the management of Type 1 DM. Accordingly, therapeutic interventions targeting helicopter parenting, psychological resilience, anxiety, depression, and self-efficacy may contribute to improving treatment adherence. Keywords: Diabetes Mellitus; DM; helicopter parenting; medication adherence; treatment adherence; self-efficacy; psychological resilience.